| NPI | 1811158736 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: IN 01069112A) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IN 11014471A) |
| Enumeration Date | 2008-06-23 |
| Last Update Date | 2021-02-15 |